• Panic Disorder Screening Form

  • This is a screening tool to help you determine whether you might have Generalized Anxiety Disorder that needs professional attention. This screening tool is not designed to make a diagnosis but to be shared with Summit Behavioral Health mental health professional to inform further conversations about diagnosis and treatment. One of our providers will perform a free review of your form and contact you to discuss potential care options

  • INSTRUCTIONS

    1) Fill and submit shown form

    2) Choose if you want to be contacted by Summit BHP staff

    3) Select date/time for brief virtual meeting

  •  -  -
    Pick a Date
  •  
  •  
  •  
  •  
  •  
  •  
  •  -
  • Summit Behavioral Health

    2115 County Road D East, Suite C-100, Maplewood, MN 55109

    Ph: 651-358-7020                           www.SummitBHP.com

  • Should be Empty:
Jotform Logo
Now create your own JotForm - It's free! Create your own JotForm